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Pak JS, Wang EY, Lee K, et al. Diagnostic yield of repeat evaluation for asymptomatic microscopic hematuria after negative initial workup. Urol Oncol. 2020;39(5):300.e1-300.e6doi: 10.1016/j.urolonc.2020.11.032.
Pak, J. S., Wang, E. Y., Lee, K., Pina, L. A., McKiernan, J. M., & Anderson, C. B. (2021). Diagnostic yield of repeat evaluation for asymptomatic microscopic hematuria after negative initial workup. Urologic oncology, 39(5), 300.e1-300.e6. https://doi.org/10.1016/j.urolonc.2020.11.032
Pak, Jamie S, et al. "Diagnostic yield of repeat evaluation for asymptomatic microscopic hematuria after negative initial workup." Urologic oncology vol. 39,5 (2021): 300.e1-300.e6. doi: https://doi.org/10.1016/j.urolonc.2020.11.032
Pak JS, Wang EY, Lee K, Pina LA, McKiernan JM, Anderson CB. Diagnostic yield of repeat evaluation for asymptomatic microscopic hematuria after negative initial workup. Urol Oncol. 2021 May;39(5):300.e1-300.e6. doi: 10.1016/j.urolonc.2020.11.032. Epub 2020 Dec 15. PMID: 33339726.
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Urol Oncol. 2021 May;39(5):300.e1-300.e6. doi: 10.1016/j.urolonc.2020.11.032. Epub 2020 Dec 15.

Diagnostic yield of repeat evaluation for asymptomatic microscopic hematuria after negative initial workup.

Urologic oncology

Jamie S Pak, Elizabeth Y Wang, Kevin Lee, Luis A Pina, James M McKiernan, Christopher B Anderson

Affiliations

  1. Department of Urology, Columbia University Irving Medical Center, New York, NY.
  2. Department of Urology, Columbia University Irving Medical Center, New York, NY. Electronic address: [email protected].

PMID: 33339726 DOI: 10.1016/j.urolonc.2020.11.032

Abstract

PURPOSE: The American Urological Association guideline for asymptomatic microhematuria recommends in patients with a negative initial workup, repeat workup should be considered for those with persistent/recurrent microhematuria. However, there is little data on the yield of repeat evaluation. Our hypothesis was that repeat workup yields a low detection rate of urologic malignancy.

MATERIALS AND METHODS: We retrospectively reviewed all patients at our institution who underwent microhematuria workup with cystoscopy and upper tract imaging from May 2010 to June 2016. Microhematuria was defined as ≥3 RBCs/HPF on a properly collected specimen in the absence of a benign cause. Demographics, age, smoking history, history of radiation, and findings on repeat cystoscopy and imaging were collected. Our primary endpoint was a new diagnosis of urologic malignancy.

RESULTS: Our initial cohort included 1,332 patients, of whom 21 were diagnosed with urothelial carcinoma and 7 with suspicious renal masses on initial workup. A total of 637 patients with negative initial workup had persistent/recurrent microhematuria. Repeat cystoscopy was performed in 161 (25%) patients at a median of 39 months, and repeat upper tract imaging was performed in 317 (50%) patients at a median of 39 months. Overall, repeat cystoscopy revealed new bladder cancer in 2 (1.2%) patients and repeat imaging revealed new suspicious renal mass in 4 (1.3%) patients.

CONCLUSIONS: We observed a low number of newly diagnosed malignancies among patients with persistent/recurrent asymptomatic microhematuria who had a prior negative workup. Additional research is required to determine the utility of a repeat AMH workup.

Copyright © 2020 Elsevier Inc. All rights reserved.

Keywords: Cystoscopy; Hematuria; Kidney neoplasms; Urinary bladder neoplasms; Urologic neoplasms

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